THE SOURCE BLOG

HEALTHCARE COSTS

The theme last month in litigation and enforcement action seems to be drug pricing. As the national debate surrounding rising prescription drug prices continues to heat up, we are seeing increasing legal action targeting the cause of such price hikes at the private, state, and federal levels. In our highlights this month, we look at how drug manufacturers and pharmacy benefit managers are coming under fire for their drug pricing practices, and how two states have turned to the Supreme Court to salvage their laws designed to rein in rising …

A New York Times article came out today highlighting how hospital mergers result in higher healthcare prices to patients, based on research and analysis conducted by UC Berkeley’s Nicholas C. Petris Center. While hospitals claim that consolidation would save consumers money, the opposite is true due to reduced competition resulting from the consolidation. In addition to continued consolidation of hospitals across the country, the article suggests there is a growing trend of large hospital systems buying up doctors’ groups and medical practices. According to Richard Scheffler, Director of the Petris …

There are 22,500 estimated injecting drug users (“IDUs”) living in the city of San Francisco. In 2015, males accounted for 71.4% of IDUs[1] and in 2017, the city recorded 100 deaths due to injected drug overdose.[2] For those who live in San Francisco, this number may not be so alarming. The majority of San Francisco’s injecting drug users are homeless – meaning drug consumption often occurs in public spaces. The short walk from City Hall to the Civic Center Bart station is overwhelmed by people injecting drugs in broad daylight. …

Happy November! We hope you are enjoying football season and preparing for turkey! In this edition of the Source Roundup, we cover five academic articles and reports from October. The topics this month include (1) the popularity of telemedicine for employers and employees, (2) an integrated health care system that combines ACO and bundled payment, (3) health spending growth in the coming years, (4) Maryland’s new initiative reduced hospital utilization and costs, and (5) how to remedy recent generic drug price hikes. Telemedicine Is More Widely Available, But Take-up …

Within the past few months, federal agencies passed two major healthcare regulations that could have significant consequences to the healthcare market. The Department of Labor (DOL) issued a final rule on Association Health Plans (AHPs) that expands the definition of “employer” under the Employee Retirement Income Security Act (ERISA), and the Departments of Health and Human Services (HHS), Labor, and Treasury issued a final rule that expands access to short-term, limited-duration coverage plans (STLDs). The two plans should not be conflated with each other as they offer health insurance coverage …

Welcome to October! We hope you are getting your costumes picked out and finding those deals to stock up on trick-or-treat candy. In this edition of The Source Roundup, we review five academic articles and reports from September that stood out to us. This month we look at (1) price inflation in the California fully-insured large group market, (2) forward motion in drug price transparency laws, (3) the future of pharmaceutical reference pricing in the U.S., (4) lessons learned from California’s competitive healthcare model, and (5) paths to universal coverage …

In this installment of The Source’s Spotlight on State Drug Legislation, we focus on price gouging prohibitions. In 2017, Maryland became a pioneer among states addressing rising drug costs when it passed the first law (HB 631) to prevent price gouging in the pharmaceutical market. At the start of 2018, fifteen states were poised to follow in Maryland’s footsteps and adopt new or strengthen existing price gouging laws to include pharmaceuticals (see Map and Table 1). In April 2018, however, the 4th Circuit Court of Appeals declared Maryland’s law unconstitutional, …

This month we highlight new developments in several high profile antitrust enforcement cases and pharmaceutical legal actions, including 1) new challenges to the proposed Beth Israel-Lahey merger, 2) expanded probe into generic drugs price-fixing scheme, 3) conclusion to Allergan’s patent saga, and 4) the future of Maryland’s price gouging law. Massachusetts Health System Merger Hits Roadblock, with Rocky Road Ahead We have our eye on the proposed merger of Beth Israel Deaconess Medical Center and Lahey Health, which has been under regulatory review since December 2017. As we covered …

Happy August! In this edition of the Source Roundup, we cover four academic articles and reports from June and July. The topics this month include: (1) price transparency as a means to affordable health care; (2) effect of state-based individual mandates; (3) Trump’s 5-Part Medicare Part D plan; and (4) Medicare’s experiment with bundled payments. Price Transparency Goals to Achieve Affordable Health Care Skeptics have questioned whether consumer price transparency initiatives are an effective means of driving down healthcare costs. In the NEJM Catalyst article, “Defining the Goals of …

Year two of California’s 2017-2018 legislative session continues to be an active one with the introduction of new innovative healthcare bills. As lawmakers work diligently, this month’s California Legislative Beat continues to look at some 2018 bills that can potentially change the California healthcare landscape. AB 2499: This bill would increase the medical loss ratio (MLR) by 5%, from 85% to 90% for a health plan or health insurer in the large group market, and from 80% to 85% for a health plan or health insurer in the individual market. …